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Prosthetic Heart Valves Differential Diagnoses

  • Author: Eric M Kardon, MD, FACEP; Chief Editor: Richard A Lange, MD, MBA  more...
 
Updated: Feb 18, 2015
 
 

Diagnostic Considerations

Other conditions to consider in patients with prosthetic heart valves include the following:

  • Hemolytic anemia
  • Thromboembolic disease
  • Cardiac conduction disturbances

Prepare patients with acute primary valve failure and severe hemodynamic compromise for surgery as quickly as possible. Delays in surgery to pursue diagnostic testing result in increased mortality.

Consider PVE in any patient with a prosthetic valve and a fever.

Pregnancy

Some debate exists concerning the most advantageous method of providing adequate anticoagulation in pregnant patients with mechanical prostheses.[18]

Warfarin increases the chance of spontaneous abortion and stillbirths and is associated with teratogenicity from 6-12 weeks gestation.

Current recommendations are to use heparin from 6-12 weeks and from 38-40 weeks gestation. Warfarin may be used for the remainder of pregnancy.

The American College of Obstetrics and Gynecology has recommended against using low molecular weight heparin in pregnancy.

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Eric M Kardon, MD, FACEP Attending Emergency Physician, Georgia Emergency Medicine Specialists; Physician, Division of Emergency Medicine, Athens Regional Medical Center

Eric M Kardon, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Medical Association of Georgia

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

A Antoine Kazzi, MD Deputy Chief of Staff, American University of Beirut Medical Center; Associate Professor, Department of Emergency Medicine, American University of Beirut, Lebanon

A Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Richard A Lange, MD, MBA President, Texas Tech University Health Sciences Center, Dean, Paul L Foster School of Medicine

Richard A Lange, MD, MBA is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American Heart Association, Association of Subspecialty Professors

Disclosure: Nothing to disclose.

Acknowledgements

Mary C Mancini, MD, PhD

Professor and Chief of Cardiothoracic Surgery, Department of Surgery, Louisiana State University School of Medicine in Shreveport

Mary C Mancini, MD, PhD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Surgeons, American Surgical Association, Phi Beta Kappa, and Society of Thoracic Surgeons

Disclosure: Nothing to disclose.

Judy Lin, MD

Disclosure: Nothing to disclose.

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Medtronic Hall mitral valve. Reproduced with permission from Medtronic, Inc.
The Hancock M.O. II aortic bioprosthesis (porcine). Reproduced with permission from Medtronic, Inc.
Starr-Edwards Silastic ball valve mitral Model 6120. Reproduced with permission from Baxter International, Inc.
Carpentier-Edwards Duralex mitral bioprosthesis (porcine). Reproduced with permission from Baxter International, Inc.
Carpentier-Edwards Perimount pericardial aortic bioprosthesis. Reproduced with permission from Baxter International, Inc.
St. Jude Medical mechanical heart valve. Photograph courtesy of St. Jude Medical, Inc. All rights reserved. St. Jude Medical is a registered trademark of St. Jude Medical, Inc.
Edwards Sapien transcatheter aortic valve.
 
 
 
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